GP CLINICAL: Inhaled steroids are best at lower doses.(asthma treatment)

New guidelines on asthma indicate that high doses may not be best practice, says Dr Martin Duerden

Inhaled steroids are an essential part of asthma treatment for many patients.

However, it has become increasingly apparent that for most people, the maximum benefit from these drugs occurs at relatively low doses.

The new British Asthma Guideline, developed by the British Thoracic Society and the Scottish Intercollegiate Guideline Network (BTS/ SIGN) was published in February this year.

Regular preventer therapy is recommended at step two, but there is an important change from the previous advice. At step two, both adults and children should be started on inhaled steroids at a dose appropriate to the severity of disease, rather than at a high dose.

It suggests 400mu g of beclomethasone propionate or equivalent as an appropriate starting dose for many adults, although up to 800mu g may be prescribed.

The guidelines …